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Compassion-Focused Therapy to reduce anxiety and depression

—Posted by Marie.Bloomfield
on 25 Feb. 2015

If you want others to be happy, practice compassion. If you want yourself to be happy, practice compassion- Dalai Lama

Compassion focused therapy (CFT) is a system of psychotherapy developed by Paul Gilbert*. It started as a modified cognitive behavioral therapy that included the concept of self-compassion.Over time it included various frame works such as evolutionary psychology, social psychology, developmental psychology, Buddhist psychology, and neuroscience. A key concept is that compassionate mind training promotes inner experiences of understanding, safety, warmth and comfort which in turn will reduce anxiety and depression.

Studies have shown that we can learn to be more kind to ourselves and to especially replace the inner critic with a compassionate voice to ease difficult emotions, to build inner resources, strengths and motivation. It has been found that people who rate higher in self-compassion experiences more positive emotions, more well-being, better quality of life and more satisfying relationships.

CFT uses a definition of compassion grounded in the Buddhist tradition, which defines compassion as a response to suffering in self and others, with a commitment to try to alleviate and prevent it (The Dalai Lama,2001). CFT is part of a growing global movement that recognizes the potential of compassion to provide benefits in a range of sectors, from business, education and healthcare to science, research and the environment (Charter for Compassion; http://charterforcompassion.org/).

Compassion as a Psychotherapeutic intervention

We have known for many centuries that compassion is key to counselling. But it is only recently that it was developed as the main focus for clinical intervention and research. Paul Gilbert, over 20 years ago, while applying Cognitive Behavior Therapy (CBT), noticed that some individuals, even if they found some valid alternative way of thinking about their situation, still did not feel any better. This led him to explore ways we can train our mind to feel comforted by developing a helpful, friendly, compassionate voice, as well as practising a range of mindfulness exercises and visualizations to assist in managing difficult emotions. In CFT, the aim is to care for our own well-being, to attend to our needs and distress and to give warmth and understanding to ourselves when we struggle rather than punishing ourselves. The Mindfulness techniques used are varied, but the key is the use of self-comforting inner language. In developing a compassionate voice, we are able to cultivate a calm and peaceful self which is encouraging, motivating and uplifting.

Paul Gilbert says: “It is not your fault… but you are responsible!”. Evolution has left us with a flawed system. We are stuck with a brain that we did not design, which contributes to reacting in ways we don’t want. In addition, we did not choose our family of origin nor did we want all the life experiences that shaped us, but despite this, we are still responsible for what we make of our lives and how we react to the world. We are all in this life together, with the same human condition so we need to support ourselves and others because life is tough for all of us.

We know that the way we behave and feel is in part conditioned reactions from our brain that have evolved over millions of years as well as being a consequence of our own early childhood experiences. Dr Paul Gilbert proposed that we have three main types of emotion regulation systems (see the 3 circles model below):

(1) the threat detection- protection system

(2) the drive-wanting- excitement system; and

(3) the soothing-contentment-caring system

The first two systems belong to the early or reptilian brain while the latter was developed in our brain later (mammalian brain) with the evolution of the attachment behaviour such as the way a mother attends to her baby(caring) as well as the way we seek to be with one another(affiliative). We naturally seek kindness and support from others to calm away threats and to feel safe. Paul Gilbert believes that the caring-affiliative system was designed as a threat regulator to help us relax and manage difficult feelings. We feel safe with our loved one, especially, when under threat because we know intuitively that we will relax when we are with them. Neurobiology has demonstrated that when we feel good with others, specific endorphin and oxytocin systems (soothing system) are produced which can also be activated when we care for others or we attend to ourselves with kindness. The absence of threat does not necessarily trigger the soothing-safe system or the calming-reassuring affiliative response. The 3 systems are necessary and the aim in Compassion-Focused therapy is to restore balance because often the threat-system or wanting-system are over active causing excessive anxiety, anger or depression while the soothing-caring system is under active, especially if we are constantly stressed. The aim of Compassion-Focused Therapy is to understand how the 3 emotional system affects us and to develop ways to activate the soothing system to regulate the other two systems to build up psychological acceptance, resilience and flexibility.

*Paul Gilbert, a British Clinical Psychologist, is the founder of Compassion Focused Therapy (CFT), Compassionate Mind Training (CMT) and author of various books. Until 2011, Dr Paul Gilbert was head of the Mental Health Research Unit, Derbyshire Healthcare NHS Foundation Trust. He made his mark in Mental Healthcare and was awarded in 2011 Gilbert the Order of the British Empire (OBE).